| Organization Name: | KALOS COUNSELING AND DIAGNOSTICS, PLLC |
| NPI Number: | 1376872986 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BENJAMIN SCOTT ODOM (MANAGER) |
| Mailing Address: | 1091 N Main St Vidor |
| State: | TX US |
| Postal Code: | 776624339 |
| Phone Number: | 4097698910 |
| Fax Number: | 4097698914 |
| NPI Enumeration Date: | 12/09/2009 |
| NPI Last Update Date: | 12/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 62334 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |